Indefinite Azacitidine Treatment Until Progression May Provide Long-Term Disease Control in Elderly Patients with Acute Myelogenous Leukemia

Abstract

The prognosis of acute myelogenous leukemia (AML) is poor in elderly patients. The mean survival rates at second and fifth years for AML were 10% and 2%, respectively. Here our aim was to demonstrate that the survival rate can be prolonged by long-term azacitidine (AZA) treatment. Complete remission was achieved at the end of the fourth and sixth courses of AZA treatment in three elderly patients with AML with a high blast count. The first patient was followed without any treatment after getting complete remission with four courses of AZA, and at the end of 1 year follow-up, the patient died due to pneumonia. Complete remission was obtained in the second and third patients after four and six courses of AZA, respectively. Second patient is still being followed up in complete remission at the end of the 20th course of AZA. Recurrence occurred at the end of the 16th AZA course in the third patient and he died after 20 months of the treatment. In elderly patients with AML with a high blast count, the continuation of AZA treatment improves the overall survival rates.